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Efficacy of 3 Nutritional Supplements to Improve Diverse Outcomes in Children Under 2 Years of Age and Pregnant Women

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ClinicalTrials.gov Identifier: NCT00531674
Recruitment Status : Completed
First Posted : September 19, 2007
Last Update Posted : November 7, 2014
Sponsor:
Collaborators:
Secretary of Social Development
Inter-American Development Bank
Information provided by:
Mexican National Institute of Public Health

Brief Summary:

The Mexican poverty alleviation program, Oportunidades provides a fortified food supplement to all beneficiary children under 2 years of age, and all pregnant and lactating women. Consumption of the supplements is well below recommended levels and the impact of the program on child growth and anemia is less than anticipated. This is likely due to a high degree of dilution by sharing of the supplements with other family members. We have also found evidence of a very high prevalence of overweight and obesity among beneficiaries of Oportunidades in both women and children.

Given the micronutrient content of the fortified food, it is likely that the impact of the program on child growth and the micronutrient status of women and children would improve considerable if the supplements were consumed daily in the recommended dose. This may be difficult, given the wide-spread sharing within households - something that has been identified by many beneficiary families as a desirable behavior. At the same time, we do not know whether daily consumption of the food, which contains approximately 20% of daily energy requirements, may contribute to undesirable weight gain in this population.

In this context, we have designed a cluster randomized controlled efficacy trail to compare the nutritional impact, acceptability and use of three nutritional supplements. Supplements were randomly assigned at the community level (n=54), and pregnant women (n=750) and children 6 to 12 mo of age (n=900) invited to participate. The principal objective of the study is to compare the impact of Sprinkles and Nutrisano/Nutrivida using syrup/pills as a positive control group, on child growth, weight gain and retention in pregnant women, and micronutrient status of women and children. We hypothesize that weight gain will be greater in the food group compared to the other two supplementation groups, but impacts on micronutrient status and length growth in children will be similar.


Condition or disease Intervention/treatment
Healthy Dietary Supplement: fortified milk-based beverage Dietary Supplement: Sprinkles Dietary Supplement: tablets Dietary Supplement: Fortified milk-based pap Dietary Supplement: Syrup

Study Type : Interventional  (Clinical Trial)
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Investigator)
Study Start Date : September 2005
Primary Completion Date : October 2007
Study Completion Date : October 2007

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Experimental: 1
Nutritional supplementation for pregnant and lactating women
Dietary Supplement: fortified milk-based beverage
Fortified with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.
Other Name: Nutrivida
Dietary Supplement: Sprinkles
Powder with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.
Other Name: Vita-mine for pregnant and lactating women
Dietary Supplement: tablets
Multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.
Experimental: 2
Nutritional supplementation for children
Dietary Supplement: Fortified milk-based pap
Fortified with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for children.
Other Name: Nutrisano
Dietary Supplement: Sprinkles
Powder with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.
Other Name: Vita-mine for children
Dietary Supplement: Syrup
Multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.



Primary Outcome Measures :
  1. Child linear growth and weight gain [ Time Frame: 24 mo of age ]
    Child height and weight at 24 mo of age and increment from baseline to 24 mo of age

  2. Child hemoglobin concentration and anemia prevalence [ Time Frame: 10 mo of supplementation, at 24 mo of age, 6 mo after completion of supplementation (30 mo of age) ]
  3. Pregnancy weight gain and weight retention [ Time Frame: 37 wks pregnancy, 1 and 3 mo postpartum ]
  4. Hemoglobin concentration and anemia prevalence [ Time Frame: 37 wks pregnancy and 1 mo postpartum ]

Secondary Outcome Measures :
  1. Acceptability and use of the supplements (women and children) [ Time Frame: Children: after 2, 6 and 12 mo consumption; Women: following completion of trial and in pregnant women who did not participate in main study ]
  2. Physical activity in children [ Time Frame: after 4 and 12 mo of supplementation ]
  3. Language adquisition and motor milestone development in children [ Time Frame: Throughout follow-up ]


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Ages Eligible for Study:   6 Months to 12 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Pregnant women before 27 wks pregnancy (Arm 1)
  • 18 yrs of age and older (Arm 1)
  • Children 6 to 12 mo of age (Arm 2)
  • Beneficiaries of the Oportunidades programa (Arm 1 and 2)

Exclusion Criteria:

  • Severe anemia (Arm 1 and 2)
  • Consuming other nutritional supplements and unwilling to descontinue use (Arm 1 and 2)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00531674


Sponsors and Collaborators
Mexican National Institute of Public Health
Secretary of Social Development
Inter-American Development Bank
Investigators
Principal Investigator: Lynnette M Neufeld, PhD National Institute of public Health

Additional Information:
Responsible Party: Armando Garcia Guerra, National Institute of Public Health
ClinicalTrials.gov Identifier: NCT00531674     History of Changes
Other Study ID Numbers: NIPH472
First Posted: September 19, 2007    Key Record Dates
Last Update Posted: November 7, 2014
Last Verified: November 2012

Keywords provided by Mexican National Institute of Public Health:
Efficacy of public health intervention (nutrition)